I use GE only for creating the track maps, which I then import to TransDem Trainz Edition. I get my elevation maps (DEMs) from the USGS Seamless Server (for the USA), then merge the pieces in TransDem, add the track maps to create my route.
I also use GE for rough images which can be used in TransDem to create ground textures that will help you in placing your scenery objects and painting the final textures. Note that you can get more detail from the GE images in TransDem by downloading and installing the additional texture files. See the TransDem manual for this process.
Once the route has been created, you need to grade your track (add tunnels, bridges, and generally smooth out the bumps), add junctions, etc. It is a time consuming and often tedious process, but this has been my method for creating prototype routes for years.
I am currently working in GE (free edition) to create a track map of the entire USA! I have much of the northeast complete so far. From these track maps, I can select any state(s) to import to TransDem to create a route in a specific area.
Happy Demming
FW